Female and Male Reproductive Anatomy Flashcards
The pelvic floor is formed by the bowl-shaped pelvic diaphragm which includes what?
The coccygeus and levator ani muscle group (LAM)
What makes up LAM?
puborectalis, pubococcygeus, iliococcygeus
The diaphragm attaches to a thickening in the obturator fascia known as what?
The tendinous arch of levator ani, which covers the obturator internus muscle overlying the lateral pelvic wall
What is the anterior gap in the medial borders of the LAM that allows passage of the urethra, and the vagina in females?
Urogential hiatus
What is mostly tonically contracted-resists increases in intra-abdominal pressure
Supports abdominopelvic viscera and
assists in maintaining urinary and fecal continence?
Urogential hiatus
What is actively contracted during activities and is innervated by the levator ani nerve, inferior rectal n, and coccygeal plexus?
Urogential hiatus
What nerve is injured during vaginal birth and pelvic reconstructive procedures?
The levator ani n
Arises from ventral sacral rami of S4 mostly
Disruption of what nerve leads to pelvic floor dysfunction and urinary incontinence and prolapse of pelvic viscera?
Levator ani n
What is a muscular tube located between the bladder and the rectum and inferior to the uterus?
Vagina
Opens through the perineal membrane into the vestibule
The vagina is about how long?
8cm
What is the vagina supported by?
The pubovaginalis part of the levator ani m. and the perineal membrane
Where does the urethra in females begin?
At the internal urethral orifice of the bladder
What does the urethra pass through?
The external urethral sphincter, perineal membrane then through the perineum and vestibule
What does the superior part of the vagina surround?
The cervix of the uterus
What is culdoscopy?
Tool to examine the uterine tubes or ovaries
What is culdocentesis?
To aspirate fluid from the rectouterine pouch
What is the arterial supply of the uterus, ovary, and vagina?
Ovarian, uterine and vaginal artery
Where does the ureter pass in relation to the uterine artery?
The ureter passes the uterine artery along the lateral sides of the uterus
The uterine arteries enter the sides of the uterus through what?
The broad ligament
Branches of the uterine arteries ascend and descend to anastomose with what?
The vaginal arteries and the ovarian arteries
What are the surfaces of the uterus?
Vesical surface and intestinal surface
What are the parts of the uterus?
Fundus Uterine horns Body of the uterus Cervix of the uterus (with cervical canal) Fornices External os Internal os
What are the layers of the uterus?
Endometrium
Myometrium
Perimetrium
What are the parts of the uterine tubes?
Isthmus, ampulla, infundibulum, fibriae, ovary
What do the uterine tubes transport?
The ovum to the uterus and is 10 cm long
The distal ends of the tubes are open to what?
The peritoneum
The fundus of the uterus is normally in what position?
Anteverted and anteflexed
The axis of the uterus is angled anteriorly (relative to the vagina) and the top of the fundus “flexes” anteriorly over the bladder
If the uterus is not anteverted and antiflexed, what does it caused?
Increased intra-abdominal pressure can push the uterus inferiorly
Contributes to prolapse of the uterus
What is a double layer of peritoneum that “drapes” over the uterus and associated structures?
The broad ligament of the uterus
What encloses the round ligament of the uterus as it extends from the anterior-lateral part of the uterus to the deep inguinal ring?
The broad ligament
What are condensations of endopelvic fascia that support the uterus and attach to the lateral sides of the uterus and vagina?
Transverse cervical ligaments
What vessels and nerves run through (or along) the transverse cervical ligaments?
Uterine vessels
What are condensations of endopelvic fascia that extend from the sides of the cervix to the sacrum?
Uterosacral ligaments
What are the parts of the broad ligament?
Mesoalpinx mesovarium mesometrium suspensory ligament of the ovary round ligament of the uterus ligament of ovary
The ligaments help to support the uterus, but what are extremely important in preventing prolapse of pelvic structures?
Levator ani muscle and the perineal body
The ovaries are suspended from the lateral pelvic wall by what?
The suspensory ligament of the ovary which contains ovarian arteries, veins, nerves and lympatics
The inferior part of the vagina is innervated by what?
Somatic branches from the internal pudendal n
The middle and superior parts of the vagina and the uterus are innervated by what?
Visceral nn.
- uterovaginal plexus (part of pelvic plexus)
- sympathetics form lumbar splanchnics
- parasympathetics from pelvic splanchnics S2, S3, S4 (motor to the uterus and vagina)
Where are anesthetic agent injected into for spinal block?
The subarachnoid space between L3 and L4.
Produces complete anesthesia below the waist. uterine contractions cannot be felt
What do peripheral nerve blocks allow?
Sensation of uterine contractions
What occurs during the pudendal block?
Blocks S2, S3, and S4 dermatomes and the inferior part of the the vagina.
What is the landmark for a pudendal block?
Sacrospinous ligament
What abolishes sensation in the anterior vulva?
Ilioinguinal block
In a peripheral nerve block, the pundendal and ilioinguinal block must be preformed. What may also need to be anesthetized?
The posterior femoral cutaneous nerve (perineal branches)
What is superior to perineal membrane and embedded within sphincter urethrae (external urethral sphincter) in males?
The bulbourethral glands
What do bulborethral glands open into?
Spongy urethra
What lubricates the urethra?
Mucus-like secretions from the bulbourethral glands
Lymphatics - the prostate drains primarily into what?
internal iliac nodes
lymphatics - the bladder drains primarily to what?
external iliac nodes
Lymphatics - the perineal structures drain primarily to what?
Superficial inguinal nodes
